Provider Demographics
NPI:1811182959
Name:BRANCH MEDICAL CLINIC BAHRAIN
Entity type:Organization
Organization Name:BRANCH MEDICAL CLINIC BAHRAIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUMED UBO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:CONDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-401-3643
Mailing Address - Street 1:PSC 851
Mailing Address - Street 2:BOX 340
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09834-0004
Mailing Address - Country:US
Mailing Address - Phone:011-390-9556
Mailing Address - Fax:0113909-556-3898
Practice Address - Street 1:PSC 851
Practice Address - Street 2:BOX 340
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09834-0004
Practice Address - Country:US
Practice Address - Phone:011-390-9556
Practice Address - Fax:0113909-556-3898
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVAL HOSPITAL SIGONELLA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-12
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
2113967OtherPK